It's been a long time - a year to be precise - since I spoke about our infertility journey. There's been a lot of thinking, frustration, jealousy... every emotion you can associate with this situation! It's not been an easy decision to make but my scientific brain will always overrule any major decision. The pro's and cons were just too much to ignore. I've decided not to pursue IVF treatment.

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Why? Even prior to my diagnosis with Bipolar Disorder I knew I was at risk for some serious reactions to the massive doses of hormones and post-natal complications such as psychosis or severe depression, which yes can be managed but it puts a dark cloud on what should be a positive, happy and loving time instead of filled with anxiety and waiting for something awful to happen. Now I have bipolar disorder confirmed, these risk factors go up to a 50% likelihood of severe mental illness. The decision has basically been made for me.

It's heartbreaking, but it's the right thing to do. I couldn't knowingly go into IVF armed with this knowledge and put an innocent life in danger. I can't help but be very, very worried that I would fall into the 50% that become unwell and I fail to bond with the baby or god forbid go into psychosis and put the child in real danger. We did consider surrogacy, but in England, it's incredibly complex and expensive. Not to mention the fact I don't think I'd ever be able to have that level of trust in someone...

If I happen, by some miracle, to get pregnant naturally then we'll deal with that on a basis of extensive counselling and symptom management. I definitely wouldn't terminate a pregnancy unless it was medically necessary. I've been off contraception for 5 years now so it's safe to say it's highly unlikely I'll ever get pregnant on my own, but bodies are weird and I know it can happen to people. The other issue is my medication for bipolar. I'd have to come off it, which with type 1 is very risky.

So now I'm in a place of grieving a loss for something I never had and dealing with the anger towards my body for once again failing me. I still get horribly jealous of people who become pregnant, despite being delighted for them, it's a really confusing emotion to have. I'm happy to be the cool aunt in life, that's absolutely fine.

It's hard to believe it's been six months since I was diagnosed with Bipolar Disorder and started lithium and later on aripiprazole to manage my psychosis. I'm also struggling to believe I've spent six months in private psychiatric care and can't help but wonder how different things would have been if I'd remained within the NHS system. Something tells me I made the right decision, despite the massive expense. Each 30 minutes with my psychiatrist costs £140 and I've recently started private psychotherapy at £90 an hour. I shouldn't be paying for therapy as I have Bupa coverage for my anxiety, which is what I'm being treated for in terms of therapy, but they're refusing to pay at the moment. I hate insurance.

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So what has all this expense given me? Having now has (significant) experience within the NHS system and now six months within the private sector I know which has served me better. I have been able to have open, candid discussions with my psychiatrist which I have not been able to do previously and in case of an emergency I can access an appointment within 24 hours. Of course, if you can't talk to your prescribing doctor you're not going to make much progress and we have built a really good rapport and working relationship which I value greatly. I trust him, and I do not use that word lightly.

What about lithium? It has been my saving grace. Lithium kept me relatively stable throughout the mammoth task of finishing my degree last month; the pressure of which is what sent me into my first manic-psychotic episode six months ago. I still live in fear of another episode and every mood shift is filled with anxiety, hence the therapy. You could say I'm slightly traumatised by everything that happened and the effect it had on my family. I feel horribly guilty, as much as I know it wasn't my fault and had absolutely no control... ah control, the cornerstone of my life. Yep, I definitely need therapy! Life on lithium isn't anywhere near as scary as I thought it would be. It's a scary drug, there's no denying that, but I have few side effects apart from a tremor and some weight gain and as long as I get my levels checked every 3 months then it's all good. It does amaze me that after a decade of trialling drugs it took one appointment with my psychiatrist to nail it. I guess that's private care for you!

Aripiprazole is a bit more of a challenge. Not because of a massive side effect profile, per se, but it's piling the weight on and I'm really struggling to take it for that reason. It's the most weight neutral out of all the antipsychotics so I'm just unlucky that this combination has put what must be an extra 15lbs on me, but I daren't weigh myself to see the damage. Anorexic thoughts and behaviours are rampant so seeing that number will just be asking for chaos to reign once again. I'm trying my best and the drug is working; my symptoms are really reduced and I can function again. I don't live in a state of being constantly barraged by hallucinations and paranoia/delusions anymore which is so peaceful and calming. I can actually sit in silence again and have it be ok! The only other problem I've noticed is that while I was doing my academic writing boringness my ability to think clearly was really clouded and I couldn't phrase things properly. It's incredibly frustrating!

Overall: I think I'm doing well and learning to live with this condition and educating myself as much as I can about bipolar, much like I did with depression and anxiety. It's my way of coping. If I can understand the biology/psychology behind this then it feels easier to deal with. I just hope I stay in this place of stability and functionality.

The next big test for these drugs will be on 19th when I get my results. I'm not hopeful.

Today is World Suicide Prevention Day. This is a difficult subject, but it needs to be talked about. Suicide is all too frequent, crisis prevention care in the NHS is a catastrophe and those of us with mental illness are left to fend for ourselves. Yes, suicide can be prevented by encouraging the discussion around mental health and normalising the phrase "I'm not ok" and talking it out with friends or family, but that's only half the problem. The general public is not equipped to talk someone down from suicide without some serious ill effects to their own mental well-being. We need trained professionals to help. We need a healthcare system equipped to manage an individual intent on ending their life.

I have my own experience with suicide attempt(s) and it baffles me I'm still alive, especially after my last attempt in 2012. I was heavily addicted to benzodiazepines and alcohol, severely depressed and could feel my body giving up. I felt like a waste of space and terribly guilty for even breathing. To cut a long story short, I woke up in the High Dependency Unit following respiratory arrest and lapsing into a coma. Three days later - after going against medical advice and leaving the HDU - I was almost sectioned and taken to the local psychiatric ward. That was when I realised that people do care if I breathe or not.

Unfortunately, I have lost many friends to suicide and experienced the sheer panic of sending out police to homes and general areas and have them sat with me while until the search was completed while I sat and trembled with utter helplessness. There comes a point where you've done all you can and you hand it over and are just left waiting, praying, hoping, begging... but how do we prevent it coming to this point? What can we do if we or someone we know is feeling like this?

1. Be aware of the signs: hopelessness, anger, recklessness, talking about death, stockpiling tablets, self-harming, poor sleep (a complete list by the NHS can be found here)

2. Talking in a "judgement free zone". This will allow your friend or family member to try and talk about their thoughts and emotions without the fear of reactions or consequences.

4: Go. To. Your. GP or psychiatrist if you have one. Be honest about why you're making the appointment and you won't have to wait.

5. Don't seek out a permanent solution to a temporary problem. Play the tomorrow game. Whatever you are feeling will pass, and there are people around you willing to help. You won't be a burden. You won't cause them harm by talking about how you're feeling.